Day 170: Advice from my first semester of medical school

Today’s inane image of the day:

Love, love, love sunsets — beautiful ones really get me through the cloudy, miserable winter days.

Neuroscience midterm? Done.

After all those serious posts, I think it’s an appropriate time for a light-hearted post — so I present to you:

What first semester medical students should and should not do
Let’s start with the should not:

DO NOT wear your white coat in public places.
We all know you’re proud of your little white coat, even if it seems to be sized for a 10-year old. And we know that you want to let the rest of the world know that you’re a medical student. But while the white coat might be respected among the profession, it may evoke negative thoughts/feelings from individuals in public places. Say you’re walking into Starbucks to grab your morning cup of coffee. When the people behind you in line see your coat, these are some of the things that they are probably thinking: 1) Oy, another reminder that I need to go see my doctor; 2) I wonder how many strains of bacteria/fungi/viruses are on that coat…; 3) What is that reddish stain? IS THAT BLOOD? [even though it’s probably highlighter or red pen]; 4) Hmm, maybe I should have that “doctor” check out this hairy, discolored mole on my back…

In my opinion, white coats belong in the hospital or in settings where you are seeing patients. Not at the gas station, supermarket or Starbucks.

DO NOT pull unnecessary all-nighters.
I’ve pulled a couple of all-nighters in my time and while some were definitely justified, most of them were not. Sleep is a really important component of learning [too lazy to pull up a paper on this, anyone want to find one for me to back this claim up?] and general cognitive function, so why cheat yourself of it? THis is especially important as an M1/M2 because our sole purpose is to learn! Furthermore, as medical students in our pre-clinical years, we don’t have the excuse of being on-call or forced to work long shifts [though, I hear that’s changing? already changed?].

I personally would rather forego my favorite television shows and/or limit internet usage than a semi-good night’s rest [at least 4 hours!]. The plan is to get through at least M1/M2 without pulling an all-nighter [not only do they mess with my ability to think clearly, my tummy hurts after being up for 20+ hours].

DO NOT set your heart on a specialty [yet].
As you’ve seen from my discussions on specialties, I’ve considered a number of specialties within my mere few months as a medical student [anesthesiology, radiation oncology, clinical genetics… etc] and I still don’t feel any closer to a specialty. I came into medical school knowing that I wouldn’t fall in love with a specialty until after I rotated through at least a few of them, but I still wish I knew now. And I still don’t think it hurts to ask questions of the residents/physicians I interact with — after all, they can offer yet another layer of knowledge that you likely wouldn’t get from shadowing or rotating as a medical student.

Basically, keep your eyes, ears and options open until it’s actually necessary [i.e. not first semester… or second semester… or even second year].

DO NOT pile on the extracurricular activities [yet].
As an undergraduate, you were a jack-of-all-trades — you started an organization or successfully headed a legacy one. You volunteered at the hospital on a regular basis. You did research, attended conferences and maybe even got a publication. And you got stellar grades while doing all of that.

But in medical school, that all changes. It’s hard to put into words just how much stuff medical students need to cram into their brains within the first two years, but let’s just say it’s a lot. So much so that even just putting your sole focus on school may be just enough to pass.

Sure, there are definitely some geniuses in the mix that can somehow always do well AND get a full night’s rest AND do research AND know what happened on the latest episode of Grey’s… but they aren’t the norm. This being said, be careful about what you commit to within the first couple of weeks of classes — definitely get out there and go to a couple meetings for various clubs/organizations, but set realistic goals for extracurricular activities. Also, make sure to remember that you are first and foremost a medical student [you don’t pay 5-figures/year in tuition money just to participate in extracurriculars!].

Once you’ve gotten a feel for things, then start adding things [slowly].

DO NOT attempt to bring all or many of your textbooks with you to Starbucks/library.
If you’re like me and regularly reference textbooks for information, then chances are you purchased some or all of the textbooks on your “required” [many people get by without ever purchasing a textbook…] list. And if you’re like me, you really like to have everything you could possibly need within an arm’s length [i.e. your backpack is 3X your size AND you need an extra bag or two to carry other “necessary” things]. If these characteristics apply to you at all, then heed this advice: do not even try to bring even a fraction of your textbooks with you to where you plan to study. I’ve tried, and failed, many times [and I’ve probably ruined my back because of it!].

Instead, plan ahead and be realistic about what you’ll be able to get through in one sitting. Only plan on sitting at Starbucks for a couple hours? Then you probably won’t get through even a couple chapters of Robbins [1464 pages, hardcover… not fun to bring with you everywhere], let alone all of your Pharmacology/Anatomy/Microbiology lectures from last week that you haven’t had a chance to review yet. Choose a couple things you want to accomplish, try to triage things so that you bring the least number of books [and binders of notes] as possible. Plus, it’ll make you feel better at the end of the day to know actually got through a specific task instead of spreading yourself thin and setting unrealistic goals [that should be an entry of its own!].

DO NOT convince yourself that you’re alone in this process.
One of the most important factors that I considered when selecting a medical school to attend was the community. Did it feel supportive? Did it feel conducive to success? Did I feel like I could connect with my future peers? These were questions I asked myself and the answers ultimately led me to select OUWB. By choosing a school I felt comfortable in, I knew that when I started to despair about how impossible it seems to cram all of a 2 inch binder into my head, that I would have a great support network built from my peers.

But even if you don’t feel like you have that support within your class, when you’re feeling overwhelmed or tired or frustrated at your limited brain capacity, know that somewhere out there, there is another medical student that feels exactly the same way you do. Guaranteed, there is another human being just as stressed, anxious and scared as you feel. And I promise you that your thoughts had flitted through another medical student’s mind at some point in time. Basically, never forget that you are not alone. We all have our ups and downs, but we make it through. And even if things don’t work out for medical school, then chances are you have something else great coming your way — just be patient.

Hmmm… now that was a lot of what not to do… what can I do, anyway?

DO study. A lot.
The most important piece of advice I can give to any incoming medical student is not to fall behind. In order to do this, you really need to train yourself to study on a regular basis without the distraction of Facebook, the television, email, etc. Even if you can only unplug and focus for an hour, it’s a start. In the end, quality always trumps quantity — so 3 hours of “studying” with Facebook and 3 Google Chat windows open probably won’t be as effective as just 1 hour of focused studying. Make sure to maintain at least this baseline, and build upon it slowly. Soon enough, you’ll be a champ at this studying thing!

Keep in mind that things do come up — I found that various AMWA events could only be held in the evenings so I made sure to prepare ahead of time allowing me to be 100% at the event [and not floating off to the decussation of the spinothalamic or corticospinal tracts]. When Mike comes into town, I make it clear that we need to go to the library to study for at least a couple of hours in order to relax for the evening [after all, he’s in school too so it works for both of us], but sometimes I just take the whole day off and realize that it’l be tough to play catch-up later on.

In the end, just try to stay on-track and if you veer off for a couple of days, know that it happens to the best of us and try to get back to your regular study schedule ASAP.

DO shower regularly… especially right before the exam.
This is pretty self-explanatory. Be cognizant of your peers in the examination room…

DO incorporate regular physical activity into your schedule.
As I’ve mentioned before, maintaining your own health is very important. This and the one below it go hand-in-hand, but let’s focus on the physical activity part first.

I know it’s difficult just to get started on a regular exercise regime without the stress of medical school over your head, but try to set yourself up for success by enlisting a partner in crime, switching up your routine or participating in IM sports teams. I personally like to exercise on my own, but until I got into the habit of forcing myself out the door, I made a lot of great excuses just to put it off. I have to study. I have homework to do. The weather is bad outside. The list goes on…

In the end, it’s up to you to take care of yourself. You’ll reap the benefits from 30 minutes of physical activity each day [even if it’s 10 minutes, 3X during the day] — I can say that after I finally got over the initial hump of regularly exercising, I noticed that my energy levels increased and I felt a lot more emotionally stable [even during stressful times!]. It really makes a huge difference.

DO try to maintain a healthy diet.
Anyone close to me can tell you that I absolutely love fried carbs — chips, donuts, elephant ears… I love it all. And when it comes to exam time, you will find me munching away at these empty calories. I admit, it’s a bad habit and I’ve been working on kicking it.

On the other hand, I’ve been packing healthy lunches for myself each day and found it’s a lot harder to ruin healthy eating when all you have to eat are “healthier” things. This means packing veggies, fruits or whole grain snacks like low-fat Triscuits [and only a single serving!]. It can be difficult to keep this up, but if you’re able to keep this up for even a week or two each month [leaving a week or two for exam-stress-eating… yes, we all do it!], it could make a huge difference in the long run.

DO talk about concepts/ideas with peers.
Not only will you benefit from reinforcing your own knowledge, you will also be forging a relationship with your peers. Especially in larger medical schools when it’s sometimes hard just to get to know your own class, by using the excuse of talking about school-related things, you are getting to know more people and expanding your network.

Since our class has only 50 people, we all know each other… but I do find myself learning more about my peers as time passes.

DO make a serious effort to keep in touch with your family and non-medical school friends.
It really pays off to keep up with the world outside of the medical community. As it is, our community can be — and usually is — overwhelming. There’s a lot going on, at all times of the day. But by cutting yourself off from the rest of your non-medical world, you’re depriving yourself of the opportunity to step outside of it all for a breath of fresh air. I personally find that the rare opportunity to talk about topics completely unrelated to medicine [and school] is crucial to my well-being. Conversation on my part usually steers me right back into medicine, but listening to what’s going on in the life of a full-time engineer or graduate student or teacher is a nice way to peek outside for a moment [that is, before running back into my study room to bury my head into lecture notes!].

DO take things one day at a time.
As a compulsive planner, this was hard advice for me to swallow [not sure I’ve swallowed it completely yet, either]. I still find myself trying to plan for things many years down the road, only to feel frustrated that there’s really nothing I can plan much further out than the next week or so. Sure, I still have a forecast of where I’d like to be in X years, but you don’t know what you’re going to get with the boards or residency match [or life in general] or whatever comes afterwards. This is what medicine is. This is what life is. I’ll try as much as I can to forge a path in the direction I aspire to, but in the end, I need to focus my energy on making today the best that it can be.

DO celebrate your accomplishments.
Whether it be through a quiet night cozying up with a book or your favorite television show, a night in with your significant other, or a night out on the town with your friends, make sure to take some time to celebrate what you’ve done. Every tiny accomplishment brings you closer to your larger ones.

Sometimes if I feel discouraged by an unproductive day, I sit down and make a list of all the little things I completed during the day [laundry, dishes, listening to X number of lectures, gym, etc] and it reminds me that usually the day hasn’t been a complete wash. If I find that I’m unsatisfied with my list, then it usually motivates me to get other stuff done, or realize that I needed that time off [like today… I am exhausted, so I don’t feel particularly guilty about my lack of productivity].

What do you think of my list? Do you have any additional things to add?

Day 167: Still here

Today’s inane image of the day:

Pink pens make everything better. Well… okay, maybe they just improve my mood when I’m tired of staring at lecture notes.

Still kicking over here. Lots of studying to do for Monday… but at least this time we don’t have 2 exams in one day!

Sadly, I view this semester’s exams as a lot more high-stakes than any of the ones from last semester because remediation will be in the middle of June. Yes, that means no real summer plans if we fail even one exam.

Anyway, look forward to a couple of fun posts next week — I have a light-hearted “things you should/should not do in your first semester of medical school” list in my drafts and will be writing an entry primarily targeted at admitted students trying to make their final decision [but anyone who’s interested in our school would probably enjoy it!].

[Have a wonderful weekend!]

Day 162: Round 5 (with update)

Today’s inane image of the day:

AFFERENT vs EFFERENT — extremely important [albeit basic] Neuroscience terms.

We are quickly approaching our 5th major examination. Sadly, preparation doesn’t get any less stressful.

Expect sparse updates and a lot of images of colorful notes and misleading small, densely packed textbooks.

Any requests for photos?

Update: As I sat here in the library trying to focus on the text before me, I quickly realized that I was envious of the high schoolers at the table next to mine frantically flipping through textbooks to fill in the blanks of a homework assignment. Long gone are the days of assignments with definitive start and end times. True, one could see our studying “end time” as the examination, but let’s be realistic here, this material will inevitably undergo the vicious cycle of being learned, forgotten and re-learned. Medical school is about repetition and the hope that we can train our brains to absorb to the point of supersaturation.

Regardless of this reality, I still love the applicability of the material. In the end, I don’t think there’s anything more fascinating than the human being.

Day 159: Block 1 – Neuroscience

Today’s inane image of the day:

This is our Neuroscience block textbook — note it’s misleading size.

I’ve been waiting for the right moment to finally fill everyone in on how the first block course is going so far and I think that time has come. Keep in mind that this Neuroscience block is not a good representation of what the rest of our blocks will be like because we lost our original course director [as of halfway through winter break] and the Neurosurgery department quite graciously stepped in to save the day with only a week and a half of planning time. Not quite sure about the details on the old course director [nor is it my place to dig for this information], but the situation was out of the school’s control and at this point I’m happy that we have a Neuroscience course at all.

Bearing in mind the situation, it follows logically that things are a bit disorganized. As it is, Neuroscience is difficult to learn – there are an endless number of obscure terms, pathways described in these obscure terms and nuances that define these pathways described in obscure terms. Add this reality to the fact that scientists/physicians have barely scratched the surface of understanding exactly why, how and what this fascinating organ can do… and you have one extremely difficult course to teach, even without the added pressure of organizing how to teach it all.

The preclinical years of medical school are like taking a super-accelerated language course [with a bunch of extra stuff appended to it]. It makes sense that we need to learn the definitions of basic terms before we can go ahead and try to conjugate them in practice. But if one day the professor walks into class and only speaks in this new language that some of us have not yet acquired… well, let’s say that I felt a couple gray hairs sprout this last week.

We are lucky to have such a phenomenal group of lecturers [they are neurosurgeons!] [not so sure we have a McDreamy, though…], but some are definitely better teachers than others.

Another issue that has come up is just not knowing how to prepare for these lectures. I was studying the Histology, Pharmacology and even Embryology lectures and neglecting the Neuroscience ones because I felt lost. Furthermore, we haven’t been getting the lectures ahead of time so trying to preview the session material has been a bit like a guessing game — sure, we knew we were looking at the Ascending Tracts [great resource!] for our second lecture… but our textbook doesn’t get into that particular subject until Chapter 6, so I had to choose if I wanted to read Chapters 1-5 first OR skip to Chapter 6 [remember that whole limited amount of time to study thing leads to trade-offs]. I decided to try to read 1-5 first, but didn’t get very far prior to lecture and felt like a fish out of water while the professor was speaking [though he showed us some awesome clips and clinical material].

After forcing myself to read at least to Chapter 6 [after the lecture] and discussing some of the concepts with a classmate, I feel slightly better about trying to attack this beast, but I have a lot of a catching up to do this weekend [although the book is bite-sized and less than 300 pages, just trying to understand one page can take an hour… or two].

The most ironic part about all of this is that when I was younger I always dreamt of becoming a neurosurgeon. This fantasy was quickly shattered when I discovered that I might already be going through menopause by the time I finish residency [just kidding, but it’s a long residency] and after taking a neuroscience summer program, it was clear that the subject didn’t interest me as much as I thought it would. And now that I’m in the course, I can pretty safely eliminate neurology and neurosurgery from my list of desired specialties.

As for other updates… I think I’ve settled into an idea for my Capstone project, learned how to suture/intubate/do an ultrasound [thanks to the Emergency Medicine Interest Group!], am looking into anesthesiology again [thanks to the Anesthesiology Interest Group] and am semi-stressed about trying to get our AMWA members down to Miami for the Annual Conference in April. Oh and our midterm exam is a week from Monday.

Happy weekend, everyone! I hope you all have more exciting plans than me… haha. =)

Day 156: Fog

Today’s inane images of the day:

Usually you can see the gym relatively clearly from this view…
The empty parking lot first thing in the morning. Note the fuzzy lights.

Driving a route that you thought you knew like the back of your hand in extremely thick fog really is an experience. Suddenly, the green highway signs that you usually ignored pop out at you from nowhere like amorphous monsters. The streetlights all pose angelically with halos around them. Traffic lights hide behind a mask until the last minute. Let me assure you, this morning’s drive had me on edge.

Anyway, need to study for this quiz…

Day 155: Promoting good health

Today’s inane image of the day:

This is the second set of chocolate cupcakes I made over break… they’re significantly darker in color and more rich in chocolate flavor probably because of the addition of coffee [I also used more butter…]. [Yes, I realize that I am opposing the title of this entry with this photo. My sincerest apologies… everything in moderation!]

Instead of spending our day off [thank you Dr. King for your positive impact on our society and this wonderful 3-day weekend!] from classes sitting around and reading books [we do have a quiz tomorrow!], a number of us spent the morning or afternoon volunteering to do health screenings at a local Forgotten Harvest drop off site. At the location I went to, each of us rotated through 4 stations: blood pressure, blood glucose, flu shots and BMI. It was a wonderful opportunity to give back to the community, as well as practice our skills.

After returning home, I found a wonderfully illustrated and well-timed video entitled, “23 and 1/2 hours: What is the single best thing we can do for our health?” — I promise it’ll be worth your 9 minutes!

And here’s one more awesome video making a staircase more appealing than the escalator:

P.S. I started using Tumblr to reblog other interesting posts [all medically-related]. For the time being, I will stay faithful to the Blogger platform for my personal entries, but you should still check it out [and follow me if you have an account!]:

Day 151: Perspective

Today’s inane image of the day:

My first attempt ever at making chocolate cupcakes over break was a success! They were fluffy, chocolatey and amazing… I just had to post this image because I devoured the last one of this batch a couple minutes ago.

Even though we did a lot of waiting around [bah! lack of productivity makes me grumpy!], I definitely thought that overall the day was a positive experience. Our course director for Neuroscience is a great lecturer [albeit not as skilled with technology as the brain and scalpel] and in APM we learned about, and practiced, a full ophthalmologic [definitely had to autocorrect that one] examination. And when I say full, I mean like fully dilated pupils.

Let me preface this with the fact that I have never had my eyes examined by an ophthalmologist and have never had my eyes dilated [woohoo for good vision]. So it makes sense that I was concerned about essentially losing control [ha, totally type A medical student personality here] of my vision in one eye and it didn’t help much to hear that someone once fainted from receiving the drops. Obviously I’m still here, and I’m able to [somewhat] write this entry, so it all worked out… but it’s still an uncomfortable feeling.

[Yes, my left eye is still dilated…]

This experience and a couple of other things made me think about different perspectives. Trying to focus on my name badge with my dilated eye was painful and made me feel uncomfortable — going from normal vision to lopsided and distorted was literally like losing a part of me. A huge part of me, too. It was a completely novel perspective on eyesight — yes, prior to this experience I understood how difficult it would be psychologically to lose sight — but actually [even partially] experiencing it really made a huge difference. And the fear that accompanied the sensation came as a bit of a shock to me.

In so many ways, medicine is forcing me to see how resilient, yet fragile, we all are.

[Of course, the best part was actually being able to visualize the optic disk and fovea. Dilation really makes a world of a difference in seeing the retinal structures.]

Day 149: Brief musing on specialties

Today’s inane image of the day:

This was the sky’s “Good Morning” today — this photo was taken from a study room in O’Dowd [I highly recommend these rooms early in the morning… so peaceful to watch the sun rise].

For our PRISM session next week, each of us is required to complete the 150 question MSPI-R assessment on the Careers in Medicine website. Not surprisingly, the speciality it said I was most compatible with was OB/GYN. Huh, you ask? Haven’t you been raving about interest in anesthesiology, radiation oncology and cancer genetics? Why did you know you would get OB/GYN [beside the fact that the survey asked predictable questions]?

Well, first and foremost, I really enjoy working with the female population [which is probably why I was so involved in the Society of Women Engineers and now the American Medical Women’s Association]. Women indeed have different needs and I find it fascinating how distinct males and females react to problems or emotional expression. I love the connection and the firsthand understanding. And babies are absolutely magical.

But, I don’t know if I really want to dedicate the rest of my life to women’s reproductive health. Maybe after my clerkship I’ll change my mind. Or maybe it’ll push me more toward breast cancers. Or maybe I’ll be back here exactly where I started [hopefully not that last one!].

Bah! It stresses me out not to have a more concrete idea of where I want to and hope to be after medical school.

Day 148: Back at it again

Today’s inane image of the day:

I’m back at that whole studying thing… what happened to break?

The good thing about this new semester is that this morning’s drive wasn’t pitch black like it was the last couple of weeks of the Fall semester. I am impressed at myself for making it to the other side of winter, when the sun peeks its head out from below the horizon at a reasonable hour and actually greets us when we walk out of O’Dowd [not quite sure we will see the sun later today, but hey we’re getting there!].

We’re starting off Neuroscience with a quiz in Anatomy tomorrow… although there are only 5 questions, I counted something like 18 images with labels that we have to memorize.

I’d write more this week, but we have our first AMWA Speaker Series Discussion tonight [with our very own Dr. Nuzzarello] and a lot of planning for the future happening. At this point, I’m trying to solidify my travel plans to California for spring break and something for the summer. Oh, and I’m narrowing down my options for a Capstone project… so many things to straighten out!

Day 145: Things are moving along

Today’s inane image of the day:

MSG [Medical Student Government] got all of our white coats embroidered over the break! Now we look official. Thanks, MSG [really hard not to read that as monosodium glutamate…]!

Things this week have been relatively hectic…

I took my remediation exam on Tuesday and… passed BFCP1! Woohoo! Interestingly, I thought studying for the remediation exam was more difficult than the original exam, primarily because all of the material was already at least familiar. It was hard to gauge what I actually still remember [S. aureus = gram positive cocci in clusters!] and what I only sort of remember [Turner syndrome = 45X — for some reason this fact was more difficult for me to drill into my head]. Regardless, that hurdle has been surpassed and I was able to spend all of Wednesday not staring at books or lecture notes!

At the time that I realized I had to remediate, I was definitely frustrated with the idea that my entire winter break would be spent with this dark cloud over my head. Furthermore, the remediation exam is, in a way, a higher-stakes exam than the original because failure automatically requires course remediation over the summer and that is the last thing I want to be doing. But looking back, I do see the utility in the process and appreciate the extra push to review the material that I was weak on. I still wish I had passed the exam the first time around so I could have focused on all of my weak spots instead of just specific sections from one exam, but I guess that’s what the summer is for.

Lovely company
Mike has been home since mid-December and it has been absolutely wonderful. Although the LDR thing has been rough, things have settled down a bit and I’ve adjusted [somewhat]. Of course I would much rather just have him around, but I can’t change our current situation and in the end there are pros to the distance that I’ve come to appreciate. I plan on writing up an entry [at some point…] with tips for long distance relationships between medical and non-medical students.

Start of a new semester
We delved right into class again yesterday — it felt like an eon had passed since we last had class, but it was nice to see everyone again and catch up. There were a couple of bumps with getting the semester started, but administration is right on top of smoothing things out.

I’m not sure I’m ready to delve into the extremely deep depths of Neuroscience yet…  but there’s no turning back time at this point. Hopefully I’ll get back into my studying [and regular blog updating] routine relatively quickly since I won’t have any time to spare.

[Many of us discovered our unofficial transcripts and realized that last semester’s courses totaled to 36 credits and this upcoming one is 40 credits… I’d say that this sounds about right.]